A meta-analysis of risk factors for disability retirement in middle-aged workers

This systematic review and meta-analysis aimed to identify sociodemographic, lifestyle, and occupational risk factors for disability retirement among middle-aged workers.

Searches were conducted in PubMed, Web of Science, PsychInfo, Scopus, and Google Scholar from their inception until February 2025. Observational longitudinal studies involving workers aged 40-64 years were included. Two reviewers independently assessed the methodological quality of the studies. A random-effects meta-analysis was performed, with heterogeneity and publication bias evaluated.

From 13,899 reports, 71 reports from 39 longitudinal studies (N=7,309,799 participants) were included. The meta-analysis found that older workers, women, those with 12 years or less education, and workers in intermediate or low occupational class are at increased risk of all-cause disability retirement. Other high-risk groups include past (hazard ratio (HR) 1.08, 95% confidence interval (CI) 1.01-1.15) and current (HR 1.29, 95% CI 1.17-1.41) smokers, individuals who are underweight (HR 1.49, 95% CI 1.00-2.23) or obese (HR 1.54, 95% CI 1.31-1.81), individuals lacking physical activity (HR 1.46, 95% CI 1.04-2.06), and those who consume excessive amounts of alcoholic drinks (HR 1.43, 95% CI 1.18-1.73). Additionally, high workload (HR 1.38, 95% CI 1.23-1.56) and low job control (HR 1.47, 95% CI 1.32-1.63) also contribute to the increased risk.

This meta-analysis highlights the significant impact of being vulnerable groups, lifestyle risk factors, and physical and psychosocial work factors on the risk of disability retirement among middle-aged workers. Targeted interventions to create a supportive work environment and encourage healthy lifestyles are crucial to mitigating the risk of disability retirement.